Effect of minimally invasive surgery on the blood-brain barrier in patients with cerebral hemorrhage

BACKGROUND: This study aimed to evaluate the effect of minimally invasive aspiration of intracranial hematoma on blood brain barrier (BBB) and bleeding after secondary brain injury.METHODS: The BBB index and levels of serum myelin basic protein were compared between patients treated conventionally (dehydration, improvement of brain metabolism, and other symptomatic treatment; N.=25) and those in whom minimally invasive aspiration of intracranial hematoma was performed 6-24 hours after the onset, in addition to conventional treatment (N.=25). Ten patients with diseases of non-central nervous system and normal cerebrospinal fluid tests who were hospitalized at the same period served as a normal control group.RESULTS: The BBB index of patients treated with minimally invasive aspiration was significantly lower than that of conventionally treated group (P<0.05). Further, in both treatment groups BBB indexes were significantly higher than that of normal control group (P<0.01). Levels of myelin basic protein followed the same trend (P<0.05, minimally invasive aspiration vs. conventional treatment; P<0.01, both treatment groups vs. normal control group).CONCLUSIONS: Permeability of BBB increases in patients with cerebral hemorrhage, as reflected by the increase in the BBB index and serum levels of myelin basic protein. Minimally invasive aspiration can reduce the injury to BBB and cerebral edema.